Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Costco Wholesale Corporation

Organization Eyewear Supplier · NPI 1417341801

Costco Wholesale Corporation is an Eyewear Supplier in Southlake, Texas. Licensed in Texas. Registered with an NPI since 2015.

Licensed in
TX
In the registry since
2015

Practice location Address checks out

2601 E State Highway 114
Southlake, TX 76092-6668
Phone: (817) 749-2800
Fax: (817) 749-2817
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Eyewear Supplier (primary) Taxonomy 332H00000X · Licence CP20045 (TX)

Record details

NPI number1417341801
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCostco Wholesale Corporation
Authorized official Art Salas — Avp Optical · (817) 749-2801
Other names Costco Optical #669; Costco Optical #669
NPI enumeratedMarch 24, 2015
Last updated in NPPESMarch 4, 2020
Certification dateMarch 4, 2020
Mailing addressPo Box 35005, Seattle, WA 98124-3405

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